Abstract
M.A.
In the Western world, anorexia nervosa has long been regarded as an age-old medical syndrome and was conceded to have reached epidemic proportions in white South African females by the 1970s. On the contrary, it has been deemed to be non-existent in indigenous African females, this being attributed to the African socio-cultural preference for the fuller figure. The first clinical case in an indigenous female was reported in Nigeria (Nwaefuna, 1981). In South Africa, the first diagnosis in 1993 and earliest reporting of three cases by Szabo, Berk, Tlou and Allwood (1995) coloured the face of prevailing conceptualisation and was viewed as a nascent indication of global acculturation to a Western lifestyle and value system.
This research represents the researcher’s invitation to the reader to embark on an exploratory journey into the biographically situated experience of anorexia nervosa as revealed through the personal experience stories of three black South African female participants. With the researcher’s quest to explore this as a uniquely human, lived experience, it became essential to open up the life of each participant as the arena in which this experience unfolded, so that seminal vicissitudes as well their sense of self in the course of this experience could be gleaned. Further, the researcher shied away from a fait accompli acceptance of the acculturation discourse and sought to interrogate it by giving voice to participants’ lived sense of the relationship between this experience and their cultural identity and affiliation. As its dialectic, the researcher also allowed participants to give voice to the cultural scrutiny of their experience through the lens of their culturally-referent others. Finally, the researcher opened up some of the seminal vicissitudes of her personal experience as the space for introspection and reflection on nuances and resonance between her experience and that of participants, without a concomitant attempt to generalise about either.
Through post-modernist interpretive interactionism (Denzin, 1989), the researcher undertook a comprehensive deconstructive review of biopsychosocial discourses on the experience of anorexia nervosa, which sought to uncover and juxtapose various underlying models of human action. This review also included a feminist lens, which allowed that images and conceptions of women that exist within these discourses could be revealed, while simultaneously offering a critique of inherent culturally gendered dynamics.
Through metaphoric simultaneity, the crystallised use of personal stories, drawings and naïve sketches sought to provide deepened, complexified and, if it be so, competing accounts of participants’ experience.
The researcher drew a number of conclusions pursuant to participants’ experience of anorexia nervosa. First, that although biological factors could not be excluded, especially the role of genetics and hormones in adolescence, the exact nature thereof was beyond the scope of this inquiry and therefore inferential. Second, that although there were varying degrees of resonance in participants’ experience with some of the macro socio-cultural discourses considered, these did not appear to have been pathogenically pre-eminent. Third, that in the exploration of particular vicissitudes of participants’ family relational dynamics, the embryonic seeds and gestalt effect of their susceptibility matrix was vividly exposed.
All factors considered, the researcher stands strongly in the opinion that gleaning this as the personal experience of three black female participants and drawing in sediments of her own personal experience, anorexia nervosa is ultimately a uniquely individual experience that stands as a covert and metaphoric language of personal distress. While it may sometimes overlap with some of the dynamics that have coloured the socio-cultural landscape in different epochs, it has its own dynamics and internal logic that is uniquely and inextricably tied to the specific vicissitudes of each person’s biographically constructed self.
The specific probing of participants’ cultural identity and affiliation served to confirm that while the evolving cultural identity and affiliation of black females may be undeniable, the prevalent causal attribution of anorexia nervosa to acculturation appears to have been compellingly shown in this case to be an external and cursory one. Finally, the specific probing of participants’ experience through the eye of their culturally-referent others revealed that anorexia nervosa is culturally enigmatic. Its attribution, in participants’ socio-cultural context, to witchcraft, acculturation and especially to HIV and AIDS and attendant stigmatisation and shaming of an already deeply wounded person serves to indicate the degree of distress, isolation and rejection experienced by sufferers. By the same token, it also serves to illumine the felt equivalence of this period in participants’ socio-cultural context with HIV and AIDS.
This study represents the researcher’s endeavour to convey participants’ experience of anorexia nervosa in its richness, in an attempt to render it understandable, without any concomitant attempt to foreclose or pretence of being exhaustive. Therefore, it recognises that the understanding presented here inalienably represents the researcher’s hermeneutic circle. The reader is thus invited, if not challenged, to discern their own understanding. Finally, it offers itself as a signpost for future research into what by all accounts, stands starkly as an untapped minefield.